Individual
TERESA BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1116 SUMMIT AVE, SEATTLE, WA 98101-2831
(206) 323-0930
Mailing address
1116 SUMMIT AVE, SEATTLE, WA 98101-2831
(206) 323-0930
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00036449
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992255244
—
WA
Enumeration date
10/11/2016
Last updated
07/08/2021
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